No abstract

The great number of hip revision arthroplasties and the cementless fixation of arthroplasties has led to more and cementless hip revision operations with bone transplantation. This retrospective study shows the results of a clinical and radiological follow-up of 34 patients with an average age of 71 years and 4 months at their hip revision arthroplasty. The subjective and clinical result in the Harris-Hip-Score 3 years and 9 months (1 year 4 months-6 years 3 months) after surgery shows 67% of the patients content with the result of the revision arthroplasty. The Harris-Hip-Score shows an average of 41.1 points preoperatively and 73.2 points at the follow-up examination. The loosening-rate was 11.8%, all arthroplasties which seemed loosened radiologically had also a bad result clinically. No correlation could be shown between the age of the patients and the clinical results as well as between an additional stem revision (15 patients) and the clinical result in the Harris-Hip-Score. All revision operations were done with bone transplantation and demonstrate, that the concept of cementless fixation of acetabular component gives satisfactory results.

Introduction: Prostate cancer screening practices remain controversial among primary care practitioners (PCPs). Inconsistent guidelines and publication of large prostate cancer screening trials have failed to provide definitive guidance. This study investigates the evolution of prostate cancer screening practices and beliefs over 12 years, in Victoria, British Columbia. Methods: Questionnaires were delivered to 119 randomly selected PCPs in 2019. Descriptive analysis together with exploratory graphs and Pearson Chi-squared test for independence was calculated. The 2008 data was compared by determining if their value fell within the 2019 data’s 95% confidence interval. Results: Response rate was 69.8% (83/119); 30.1% of PCPs reported regularly screening asymptomatic men with prostate-specific antigen (PSA) testing and 37.3% reported regularly performing digital rectal exam (DRE). The combination of PSA and DRE was the most commonly used (48.2 %) screening modality. Most (73.5%) reported that guidelines influence their screening practices, with the most popular choice being those published by The Canadian Task Force on Preventive Health Care (CTF) (32.5%). Conclusions: The results demonstrate a movement away from prostate cancer screening among PCPs when compared to 2008. PCPs believe that DRE and PSA are less valuable as screening tools and that there is insufficient evidence to support their use. The most used initial screening modality was the combination of PSA/DRE, however, we found a decrease in their use between the two study periods. Clinical guidelines continue to influence PCPs screening practices, but the shift of more PCPs following the CTF guidelines since 2008 has likely led to the reciprocal decrease in prostate cancer screening.

Case: Osteopetrosis is a genetic condition that impairs bone turnover as the result of defects in osteoclast function and abnormal ossification of bone. Autosomal dominant osteopetrosis is often mild; however, the impaired fracture healing, increased density, and hardness of osteopetrotic bone present technical challenges for surgeons leading to complications with both nonoperative and operative treatment modalities. In this case report, we describe a patient treated empirically with ultrasonic bone stimulation for nonunion of fractures of multiple metatarsals after a failure of conventional therapy. Conclusion: Ultrasonic bone stimulation may have a role in optimizing nonoperative management of osteopetrosis-related fractures in adults.